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taylorzx4

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my office manager is telling us that we do not need to focus on entering the EOB's. She lets them sit around for months if not about a year. She is cashing the checks right away and we wonder how can this happen. its there a time frame we must enter them to properly balance the practice?:eek:
 
EOBs should not be sitting around for months waiting to be posted. Where does your office manager get the idea that posting payments is not important? How do you know what is patient responsibility, what needs to be appealed, etc.?

Does your office have an outside accounting firm that reviews financial records, prepares taxes, etc.? It would seem that they would be interested in making sure that all of the financial records are accurate.

Hopefully your office manager will "see the light" and realize that accurate financial records are crucial to the overall fiscal health of the practice.

Patricia Murrin, CPC, RCC
 
Oh, my....this is an accounting nightmare and this practice is in trouble...without posting the payments and subsequent write offs, there is no way for the practice to reconcile its books...how do you know what to collect as coinsurance from the patients? You most likely have a huge number in past due A/R and no one knows what the real number is. Obviously there are no checks and balances in place which usually means "embezzlement."
 
Make sure you keep all of the RA's. I would make my own billing logs and update them as the payments and RA's come in, so you can keep track of what is paid and what is still owing.

Cover Your A**
 
Does your practice have an outside book keeper or accounting firm that over sees the books? Or is this done by the office manager? You should be opening and closing the books on a monthly basis. What if the practice ever had cash flow issues and needed a line of credit or loan? How could they prove their in good shape financially with all that outstanding A/R?

What happens if you get a request for a refund? how to you resolve something like that if you have no record that the payment is posted to the patient account?

Do your providers ever review the A/R with the office manager?

This sounds like a big mess and a bit sketchy.
 
This is very odd. Is there an owner you can talk to about this?

MarcusM pointed out "Obviously there are no checks and balances in place which usually means "embezzlement.""
 
Reading this I am wondering, if there is no embezzlement going on then what other motive would there be to not be fiscally responsible. If she is the one cashing the checks, but no entries are being made then no one is watching the cookie jar here. You need an independent auditor right away!
 
Thank you so much!!!!!! you have allll confirmed exactly what we were concerned about. Is there a place we can report this without being identified?
 
I would say that you need to speak to one of the owners immediately. They definitely need to have a forensic audit done to see if there is any wrong doing or where the monies are actually going. As someone mentioned , I would definitely cover yourself with making sure copies are available of all EOB and remittances that have come into the practice. I am not sure what type of practice you are in, group or solo, but I would seek out someone who may be over your manager such as a board or physician-owner. I am dumbfounded that the practice does not have any checks and balances in place, and that no one is looking at financial reports. Private message me if your practice decides to do an outside forensic audit as my firm handles that type of work. Good luck
 
I agree with what everyone has said...that is crazy! What if a claim is paid incorrectly, or not paid at all? You only have a certain amount of time to appeal that claim (mostly 45 days from the date of EOB), so it's important to look at them thoroughly, and post them.

Also- that sounds like an accounting/auditing nightmare about to happen. I would definitely notify one of the partners.
 
taylorzx4 said:
my office manager is telling us that we do not need to focus on entering the EOB's. She lets them sit around for months if not about a year. She is cashing the checks right away and we wonder how can this happen. its there a time frame we must enter them to properly balance the practice?:eek:
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There is no regulated time frame, however if you are in private practice, this is a WARNING signal and the owners need to be made aware of what is going on and the ramifications of not tracking their accounts receivable in a timely fashion. Speak up or write an anonymous letter.
 
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